Outcomes desired

The U.S. Office of Technology Assessment has defined the quality of medical care as evaluation of the performance of medical providers according to the degree to which the process of care increases the probability of outcomes desired by patients and reduces the probability of undesired outcomes, given the state of medical knowledge (Congress of the United States, Office of Technology Assessment, 1988). 

For the job of cleaning clothes at home, Exhibit 3.2 lists a sampling of expected outcomes, desired and undesired, from both the provider s and customers perspective. See Outcome Expectations (Technique 2) for more guidance on how to identify and document desired and undesired outcomes, as well as how to determine their relative importance. 

There are several other factors that are studied depending on the nature of the reaction and the outcome desired. One may sometimes need to stndy the effect of the presence of moisture, agitation profile, exposure to air, and similar factors. 

The bottom line is this to achieve the organizational outcomes desired in the next period of economic growth, business leaders will have to sharpen their understanding of diversity and build their skills in leveraging that diversity through inclusive behavior. 

Define Indicator. The definition of the indicator to be monitored must be carefully developed. This process includes at least five steps. The event or outcome to be measured must be described. Define any specific terms that are used. Categorize the indicator (sentinel event or rate based, process or outcome, desirable, or undesirable). The purpose for this indicator must be defined, as well as how it is used in specifying and assessing the particular process or outcome. 

Extinction is a t)qje of consequence in which an outcome desired by an individual is removed following a behaviour and is withheld each time that behaviour occurs with the intention of reducing the occurrence of the behaviour. Figure 2.8.2 summarises these behaviour reinforcers. 

Both nicotinic acid and nicotinamide have been assayed by chemical and biological methods. Owing to the fact that niacin is found in many different forms in nature, it is important to indicate the specific analyte in question. For example, if biological assay procedures are used, it is necessary to indicate whether the analysis is to determine the quantity of nicotinic acid or if niacin activity is the desired result of the analysis. If nicotinic acid is desired, then a method specific for nicotinic acid should be used. If quantitation of niacin activity is the desired outcome, then all compounds (bound and unbound) which behave like niacin will assay biologically for this substance (1). 

For most color photographic systems, development is the rate determining step, and within that step the formation of semiquinone is the slow process (37). The fate of the highly reactive QDI is deterrnined by the relative rates of a number of competing processes (38). The desired outcome is reaction with ionized coupler to produce dye (eq. 3). Typically, the second-order rate constant for this process with ionized coupler is about 10 to 10 ... 

Then, list both the imperatives and desirables to be present in the results. That is, list the outcomes that must be present for the project to be considered successful, and list the outcomes that are not essential but that would add to the project s success. 

Avoid ultimatums An ultimatum requires the other party to either surrender or fight it out. Neither outcome will contribute to future cooperation. Also, avoid boxing someone in. This happens when you offer only two alternatives, neither of which is desirable to the other person. 

Removal of the carbonate ring from 7 (Scheme 1) and further functional group manipulations lead to allylic alcohol 8 which can be dissected, as shown, via a retro-Shapiro reaction to give vinyl-lithium 9 and aldehyde 10 as precursors. Vinyllithium 9 can be derived from sulfonyl hydrazone 11, which in turn can be traced back to unsaturated compounds 13 and 14 via a retro-Diels-Alder reaction. In keeping with the Diels-Alder theme, the cyclohexene aldehyde 10 can be traced to compounds 16 and 17 via sequential retrosynthetic manipulations which defined compounds 12 and 15 as possible key intermediates. In both Diels-Alder reactions, the regiochemical outcome is important, and special considerations had to be taken into account for the desired outcome to. prevail. These and other regio- and stereochemical issues will be discussed in more detail in the following section. 

The outcomes of intramolecular cyclizations of hydroxy vinylepoxides in more complicated systems can be difficult to predict. In a study of the synthesis of the JKLM ring fragment of dguatoxin, epoxide 44 was prepared and subjected to acid-mediated cydization conditions (Scheme 9.24) [114]. Somewhat surprisingly, the expected oxepane 45 was not formed, but instead a mixture of tetrahydropyran 46 and tetrahydrofuran 47 was obtained, both compounds products of attack of the C6 and C5 benzyl ether oxygens, respectively, on the allylic oxirane position (C3). Repetition of the reaction with dimsylpotassium gave a low yield of the desired 45 along with considerable amounts of tetrahydropyran 48. 

While it is desirable and important to have some knowledge of radical stabilities, the following sections will show that this is only one, and often not the major, factor in determining the outcome of radical reactions. 

A key element in planning and conducting clinical trials is to ensure that they have scientific validity and objectivity. This is particularly relevant with respect to Phase II and III studies, where it is desired to demonstrate a positive benefit to risk outcome. Responses to a drug among a patient population are rarely homogeneous and clear-cut. Thus, sound statistical principles must be applied in order to be able to distinguish significant effects from random events. 

Appropriate study design should be selected to achieve the desired outcome. A description of the type/design of frial to be conducted (e.g., double-blind, placebo-controlled, parallel design) and a schematic diagram of trial design. 

Assisting individuals irt establishing desired outcomes in thoughts and behaviours. 

Establishing the methods to help individuals achieve the desired outcomes. 

It facilitates the application of the contents of learning in real life contexts, thus enabling the evaluation of its effectiveness with respect to achieving desired outcomes. 

Accelerating the change process and driving it towards desired outcomes. 

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